MRS. DEBRA CARDELL ADEWALE (NPI# 1407910763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407910763 |
Entity Type | Individual |
Full Name | MRS. DEBRA CARDELL ADEWALE |
Credential | PAC |
Practice Address |
1141 W Redondo Bch Blvd Suite 307 Gardena CA 90247 |
Mailing Address |
5337 6th Ave Los Angeles CA 90043 |
Practice Telephone | 3107156100 |
Mailing Telephone | 3232958292 |
Mailing Fax Number | 3232941589 |
Enumeration Date | 2006-12-21 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA11301 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1141 W REDONDO BCH BLVD SUITE 307 |
City | GARDENA |
State | CA |
Zip Code | 90247 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588744627 | William Essilfie | Internal Medicine | 1141 W Redondo Bch Blvd, 307, Gardena, CA 90247 | 2006-10-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982204707 | Melissa Reyes | Home Health Aide | 835 N Rosecrans Ave Apt 125, Gardena, CA 90247 | 2020-10-30 |
1538645569 | Christopher Jabarie Markham | Case Manager/Care Coordinator | 12817 S Hoover St Apt 14, Gardena, CA 90247 | 2018-07-12 |
1013404243 | Sunshine Community Resource Organization Center | Counselor | 1202 W 135th Street, Gardena, CA 90247 | 2018-04-13 |
1124537261 | Nina Vu | Pharmacist | 14416 Plum Lane, Unit 3, Gardena, CA 90247 | 2017-09-20 |
1356871008 | Delaram Moshfegh | Pharmacist | 1735 Artesia Blvd, Gardena, CA 90247 | 2017-06-15 |
1497290522 | Better Vision Optical | Eyewear Supplier (Equipment, not the service) | 1121 W Gardena Blvd Ste A, Gardena, CA 90247 | 2016-12-28 |
1013394832 | Lydia Gonzalez | Case Management | 13605 S Vermont Ave Apt 16, Gardena, CA 90247 | 2015-04-30 |
1396147682 | Daniel Medical Group, Inc. | Acupuncturist | 2015 W Redondo Beach Blvd., Ste F, Gardena, CA 90247 | 2014-09-18 |
1386913663 | Linda Doreen Humphries | Nurse Practitioner | 1141 W. Redondo Beach Blvd., Suite 402, Gardena, CA 90247 | 2011-12-15 |
1215229547 | Everett D Wong | Social Worker | 1045 W Redondo Beach Blvd Ste 150, Gardena, CA 90247 | 2011-05-04 |
Find all providers in zip 90247 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457697674 | Madhubhai Patel | Physician Assistant | 111 W Albertoni St, Gardena, CA 90248-3543 | 2012-12-15 |
1235409566 | Alfred Fuentes Jr. | Physician Assistant | 14127 S Vermont Ave, Gardena, CA 90247-2205 | 2012-01-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.